Please! Don’t pass the salt

REUTERSResearchers believe that salt activates a type of cell involved in autoimmune conditions.

Durban - South Africans love salt. We spoon it into soups and casseroles, shake it liberally over snacks and add splashes of salty sauce to dinners.

Packet sauces and gravies, deli meats, bread and even breakfast cereals contain salt, stealthily pushing up our daily intake to risky levels. Ask us to cut down, and most of us turn a deaf ear. We’d rather forgo other guilty pleasures than ditch the salt shaker.

But things are set to change. The Department of Health’s salt reduction targets will dramatically change the eating habits of the nation – and present technical headaches for many food manufacturers, says Nigel Sunley, a technical consultant to the food industry. Sunley was speaking at a roadshow, hosted by Unilever, on salt reduction.

High-salt foods like crisps, processed meats and even unlikely culprits such as bread and breakfast cereals will have to have salt content reduced to comply with the salt reduction regulations that will come into effect in two phases – in June 2016 and June 2019. And they could even spell the demise of salt and vinegar crisps that are twice as salty as targets will need them to be.

In some foods, like breakfast cereals, salt reduction will be relatively limited – in others, like savoury snacks, substantial. High-salt foods like crisps, packet soups, stock cubes and processed meats, will undergo dramatic changes in taste as salt content is reduced to comply with legislation. For example, Simba Lays crisps contain 764 mg of sodium per 100g. By 2016, that will need to be reduced to 650mg/100g and by 2019, to 550mg/100g. Willards Cheese Puffs contain 1020 mg of sodium per 100g. The 2016 regulatory requirement will be 800mg/100g and by 2019, 700mg/100g.

“Snack foods seem to have been a major target of the Department of Health,” says Sunley, who compared the salt content of several snack foods and found that many products were way over the limits for 2016, let alone those of 2019. Some products, of necessity, contained very high amounts of salt – popcorn for example had a greater surface area and therefore contained more salt and this would pose a challenge for food manufacturers. Salt and vinegar crisps too were way over the recommendations because of the sodium diacetate added to give the vinegar flavour. The present salt content in salt and vinegar crisps (Willards) was 1730 and the 2019 regulatory requirement was 850 mg/100.

Bacon, polony and viennas were over the 1000mg/100g and would have to reduce their salt content to 850mg/100g for bacon and 650mg/100g for polony and viennas by 2019.

“There are technical issues with salt reduction when it comes to meat products,” said Sunley. “Salt has some important functions, like flavour enhancement, protein stabilisation and preservative properties. Reduced salt levels will shorten shelf life and increase microbiological risk.”

Margarines and fat spreads were also in the firing line and while some were already compliant with the 2016 and 2019 requirements, others would have to reduce salt content.

Bread raises many issues. The requirement for 2016 is 400mg/100g and for 2019 is 380 mg/100g. At present, commercial loaves range between 618mg/100g (Albany white) and 382mg/100g (Sasko white rolls).

“The proposed levels are lower than anywhere else in the world and these reductions will have significant effects on bread quality. Salt is a major contributor to dough quality, ease of handling in high volume production, fermentation control, loaf appearance and shelf life.

“Replacement with alternatives gives flavour problems and adds to the cost. Additional gluten can be added to partially offset the reduction in salt but that will push up the cost too. ‘Stronger’ wheat with a higher gluten content would improve dough quality but that would be imported. The estimated costs of replacers and increased gluten are estimated at over R600 million per annum. There are difficult times ahead.”

Most soups, gravy powders and stock cubes are way above the 2016 limits, let alone the 2019 limits.

“Stock cubes present a massive problem. Palatability will be reduced and people will add discretionary salt.

Some breakfast cereals would also become more bland in taste as their salt content was reduced and people would have to get used to the taste.

Sunley said in many categories, the targets were arguably unrealistic. Reduced salt would affect the flavour of snack foods, meats, breads, noodles, soups, gravies and stocks and reduced salt would create technical production problems for processed meats, bread and stock cubes. Shelf life would be affected in some foods.

Processed

He is not convinced of the practicality of a blanket reduction in salt content in processed foods unless it is accompanied by a major consumer education campaign on so-called “discretionary salt” – salt that is added in an uncontrolled manner by the consumer.

He believes the DoH has been excessively influenced by “the anti-salt and industry-bashing brigade” and says the benefits of salt reduction in reducing hypertension are not necessarily applicable to the whole population.

“Many studies do not show significant cause and effect and others show that excessive salt reduction is not desirable.”

Most consumers, particularly low income consumers, purchase and eat based on price and palatability and not on health considerations, he says.

He added that salt reduction strategies would only work if the government put significant resources into enforcement and the education of consumers about salt.

Lifestyle change is essential

It is estimated that most people eat between 6g and 11g of salt a day, with some salt-lovers consuming up to 40g, 55 percent of which is in the products we eat. This is way above the World Health Organisation’s (WHO) recommendation of 5g (one teaspoon) daily.

The Department of Health’s regulations will help consumers reduce their salt intake: dietitians Erika Ketterer of the Heart and Stroke Foundation of South Africa and Suna Kassier of University of KwaZulu-Natal, presented a salt-reduction scenario at a roadshow hosted by Unilever in Botha’s Hill last week.

High salt intake is a risk factor for hypertension (high blood pressure) and the WHO sees hypertension as an even greater health risk than smoking.

“Non-communicable diseases have overtaken infectious diseases as the leading cause of death,” said Kassier, “and hypertension is an important risk factor in cardiovascular disease. Reducing salt intake will make a major contribution to the prevention and management of hypertension.”

The foundation says there are 6.3 million people living with high blood pressure, and South Africa has one of the highest rates in the world. This makes us more susceptible to life-threatening diseases like stroke and heart disease. Statistics show that about 130 heart attacks and 240 strokes occur daily in South Africa. This means that every hour 10 people will suffer a stroke and five people will have a heart attack. Salt reduction has been shown to reduce high blood pressure.

Ketterer said what was needed was a massive change in behaviour and the lobby group Salt Watch had been established by the the foundation, in partnership with the health department, to encourage South Africans to eat less salt.

“We want to make people aware of the link between eating too much salt and hypertension, encouraging them to lower their use of discretionary salt – added at the table or during cooking – and to choose lower-salt products,” she said.

Salt Watch would also lobby the catering industry, as well as healthcare professionals, and an awareness campaign in the media would start next year.

Changing behaviour was not easy, said Ketterer, and many people with high blood pressure were not aware that their salt intake was too high. Research showed that township consumers were aware of the salt and health link, but they did not know why it was bad, so they distrusted the message unless it came from a doctor.

In a study of diet and blood pressure in three ethnic groups, it was found that many black people added salt to their food before tasting it and said they liked their food very salty. When cooking, they added stock cubes, soup powders and flavour enhancers, all of which contained sodium.

There were many barriers to achieving salt reduction, said Ketterer.

People lacked knowledge of high-salt foods and healthy affordable alternatives and thought meals without added salt were boring. Family members were resistant to dietary change.

“We want people to know that too much salt can lead to heart attacks and strokes, to learn which foods are high in salt and to be aware of the amount they are eating. We want them to choose foods that are low in salt and to limit the use of discretionary salt. It needs to be done slowly, over time, and there are many ways that you can add flavouring to foods without using salt.”

Besides enhancing taste, salt was used to preserve meat, particularly in rural and township communities, with roadside butchers using this practice. In shisa nyamas (braais) where large quantities of meat were consumed, salt, spices and salty seasonings were added liberally.

“Meat is part of a culture and salt goes hand in hand with meat,” said Ketterer.

In traditional, and lower to lower-middle income communities, there is a belief that salt has considerable health benefits.

“Drinking salt water regularly and taking salt-water enemas are seen as part of a healthy lifestyle,” she said. “Life is often very hard for people. They are aware that they could be living healthily, but anything that makes life a little easier (especially in basic necessities like making food palatable) is hard to give up.

“Many people do not know how to cook more healthily and others think it is only necessary if you have a health condition. Equipping consumers with knowledge and skills, using less salt and more alternatives like herbs, salt-free spices, lemon juice and garlic, and providing affordable, culturally acceptable and tasty recipes and cooking skills will go a long way in supporting behaviour change to reduce salt intake in South Africa.”

Some take reduction targets with pinch of salt

SALT reduction targets would dramatically change South Africans’ eating habits – and could present technical headaches for many food manufacturers, according to experts.

High-salt foods such as chips, processed meats and even bread and breakfast cereals, will have to have their salt content reduced to comply with the Department of Health’s reduction targets.

But experts are worried about how this will be achieved without affecting food quality.

In some foods, like breakfast cereals, salt reduction will be limited – in others, like savoury snacks, substantial. Foods such as chips, packet soups, stock cubes and processed meats will taste different when their salt content is reduced.

The department wants food manufacturers to work towards reducing salt, and has set targets for June 2016 and June 2019. It hopes reduced salt will lower the incidence of hypertension, a risk factor for heart disease and strokes.

However, Nigel Sunley, a technical consultant to the food industry, has warned of technical issues with salt reduction in meat products and bread.

“Reduced salt levels will shorten shelf life (of some foods) and increase microbiological risk for processed meats and bread,” he said.

“They will also affect the flavour of snack foods, breads, noodles, soups, gravies and stocks and create technical production problems for processed meats, bread and stock cubes.”

Sunley believed some targets were “arguably unrealistic”.

He was also concerned about lack of adherence to the regulations. “You will have ‘cowboys’ who will ignore the law and big companies that adhere to the regulations will lose out to them – and how are the laws going to be enforced? Use of discretionary salt will increase – you can’t legislate human behaviour.”

The SA Association for Food Science and Technology has also warned of safety issues, particularly regarding meat products produced in a hot country and often consumed by people not able to afford salt-replacing preservatives or refrigeration.

“If the intake of salt is going be successfully reduced, there will have to be wide-ranging awareness and education campaigns, capable of changing the salt habits of all consumers,” it said.

Dr Clif Johnston, vice-chairman of the SA National Consumer Union, said that while the union supported salt reduction, consumers should not be misled by the marketing of seasonings and stock extracts, which were “little more than flavoured salt”.

The Consumer Goods Council of South Africa is concerned that food costs could escalate.

“Research and development entail resources in order to find suitable substitute ingredients,” spokesman Mateboho Kawara said.

“Shelf life and stability tests, consumer testing and changing of packaging (labelling) may all impact on food pricing.”

Durban dietician and health store owner, Emma Mentel, believes salt is not the issue that should be receiving attention.

“Obesity, diabetes and heart disease are the big issues, caused by over-consumption of sugars, refined carbohydrates and processed foods. Limiting salt will not reduce these diseases, and hypertension is often associated with obesity, so obesity is what needs to be tackled first.”

Six ways to reduce salt

1 Cut down on processed foods – salt is found in almost every pre-prepared food, from processed meat to canned soup, to bottled dressings and packaged sauces, bread, and condiments such as ketchup and pickles.

2 Cook at home – making your own meals means that you can control how much salt you are adding, as well as increasing how many vegetables you can add to dishes. Drain and rinse canned vegetables and beans, which could reduce your salt intake from these products by up to 50 percent.

4 Read the ingredients list – if sodium or salt is listed in the first three ingredients, the food is likely to be a high-salt choice. Salt may also be “hidden” on the list as table salt, sodium chloride, monosodium glutamate (MSG), sodium nitrate, sodium bicarbonate and soy sauce – these are all salt too.

5 Read the label – some products may have a low-salt, low-sodium or no-salt-added version, but also be aware that these products may not necessarily be “healthy” if they are also high in sugar or fat.

6 Eat in – restaurants are notorious for creating salty meals, as this is an easy way to boost flavour. Ask your waiter to tell the chef to use less salt in your meal.

Source: Heart and Stroke Foundation of South Africa

How to shop for low-salt foods

* Sodium content in nutrition table: compare sodium per 100g of similar products and choose the one with the least amount of sodium.

* Choose low-sodium options more often: sodium content must be 120mg per 100g or less.

* Avoid high-sodium options: with a sodium content of more than 600mg per 100g.

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